The Hon. Greg Hunt MP
Minister for Health and Aged Care
25 March 2022
SPEECH – APP 2022
Well, thank you to Trent, to you, and to [indistinct] and to all the executives at Pharmacy Guild, to our amazing pharmacists of the year – Brooke and Brad, who I met, from Canberra.
I met Mark this morning as I was out on my walk on the beach thinking about the speech, what to say, what not to say and all the different things, and he and his pharmacy partner Sarah from Forbes, were able to win Pharmacy of the Year a few years ago.
To Lucy, from Miami, is Angie Bell’s pharmacist. Now, Angie is here with me, as the Member of Moncrieff.
The Chief Medical Officer, Professor Paul Kelly. The acknowledgement of my own staff and own team – Wendy and Alex, and so many others.
But it’s the pharmacists who are here that I particularly want to acknowledge today. Your work through the pandemic. And I’ve met so many of you. I’ve been vaccinated four times by pharmacists through flu and COVID in recent years, and all of them gentle hands, you might have missed your opportunity, but incredibly professional.
And you mentioned Trent, my wife, Paula, and I was speaking this morning, as I was on that beach I was talking with the kids as I was walking, and the family, they were in the car and my wife said to me: so what’s the theme of the speech today? And I said: it’s how we support pharmacists as they support the community.
And my daughter, who was studying for a chem test said: thanks, good summary Dad, can we talk about chemistry? And can we talk about English. It’s a tough audience, no man’s a profit in his own home, that’s for sure.
But having said that, that was actually an important way to summarise what we’re doing, and what we’re talking about. And I particularly want to do that, because this is the last time I will get to address APP – unless, of course, I come back as president of the Guild in another life. Think about it.
However, what I really want to do is focus on what we’ve done together in a unique partnership, almost unparalleled, in the last five years.
We’ve helped support you, and in turn, you supported the community. What we’re going to do though, perhaps even more importantly over the next five years, and specific, immediate initiatives that I want to announce today.
And so let’s think about the last five years. One of the first calls I made after I was appointed was to George Tambassis. And on that first day, we talked about the sixth Community Pharmacy Agreement and the challenge that was being faced, where the predictions with regards to scripts, and therefore remuneration had fallen short.
And so we set out to have both a short-term resolution and a long-term resolution. And that was the compact that we formed in 2017. And that compact addressed $210 million remuneration.
There’s a little bit of resistance from some bureaucracy that wanted an equal partnership where everybody took the risk – we said no, there’s something bigger at stake here. It’s about the long-term survival of community pharmacies.
And so there was that funding, $600 million that was released to program. But more importantly, it established the framework.
And the next big thing that we did was the location rules. And to change those location rules, I think a lot of what we’ve done with giving pharmacy that role in community vaccination through the pandemic has, arguably, been the most important of all of the reforms.
By taking away that threat, by making those locations rules permanent, we changed availability.
You know it, some of you were talking about it. We changed your ability to plan for the future. And that was hard fought, because there were many who resisted.
And what that meant though, when people ask me: why would you do that? I said: because we will need a flourishing community pharmacy sector going forward. Because it’s not just a business, it’s a health service and we never know when we would need it.
Turned out, less than three years later, we needed those pharmacies.
And you stayed at your posts. And we saw, around the world, some of the challenges. We saw Italy, Spain and France. We saw New York and London.
And our pharmacists stayed at their posts through thick and thin, because they weren’t just running a business; they were health professionals.
So those changes, I think, Trent, were some of the most important things that will have happened in pharmacy in the last thirty years, and potentially in the next 30 years.
And then that brings us to the seventh Community Pharmacy Agreement, and that agreement involved an $18.35 billion investment – $16 billion in dispensing fees, $1.2 billion in programs, and 1.15 in terms of the community service obligations and other related elements.
But most importantly, it carried with it two other things. One is indexation, so as you can see that income was increasing over the five-year period. But two, it addressed the challenge that George and I talked about on the very first day of Sixth Community Pharmacy Agreement.
And again, there are those within the bureaucracy who found that this was an extraordinary position to take, and that is we built a floor under the pharmacy remuneration, created what is sometimes known as the floor of a ceiling to provide certainty to everybody going forward. So that’s what the remuneration adjustment means.
What does this mean? It means that there’s a guaranteed minimum income. It means that you can plan. It means that we did a unique agreement, that, to the best of my knowledge, and certainly of every advice of the Department of Finance gave me, this was, unique for any long-term agreement that the Government had done with any medical organisation in Australian history.
And that again was done in the belief that underpinning support for community pharmacy, as you supported the community, was immensely important.
And then that led to the pandemic. And in the pandemic, there were three things I want to mention.
Firstly, vaccinations. And we work very hard. There was resistance amongst some states and territories and some others to the role of pharmacies in vaccination.
And yet here we are now, 3,500 pharmacies delivering, so far, approximately 6.5 million COVID vaccinations and receiving remuneration for it.
And that breakthrough was immensely important more than ever, I think, in October and November, and in January, February, immensely important giving Australians options and choice, and points of presence. But also giving them comfort. But that has been incredible.
Second, the rapid antigen tests. At this point in time, 5,500 pharmacies have delivered over 25 million concessional rapid antigen tests, and 94 per cent of pharmacies have participated in that program.
We designed that in January and now we’ve extended it to the end of July to support our concessional patients.
I doubt there has ever been a more significant set of advances in terms of pharmacy in any five-year period.
And there may be those that think there are better alternatives. But I don’t think we will ever see a period like that, and we may never see another period going forward, and we’ve been able to do that because we believe in small business and we believe in pharmacy, and we believe in the hybrid model of public and private healthcare as the Australian model. That’s the critical thing.
So then let’s look forward, and here I want to deal with scope of practice as we look at the next five years, modernisation and, in particular business liability.
In terms of scope of practice, when we look at vaccination: flu, children, COVID – all of these things have now been put in place. There’s obviously more to do on his front, but they’ve been put in place.
And that’s a sea change, and we’ll continue to expand that. And whether it’s the work in terms of diabetes, whether it’s blood work – so many other services that we’ve provided in the programs in the CPA, we’ll continue to expand that.
I want to commit that we are committed to our important theme, which is the doctoral title going forwards for people currently in pharmacies in Australia. I believe in that, that’s something that the Coalition will continue to pursue in the future. And when I given my word, we’ve delivered those in the past, and we’ll do that in the future.
Importantly, when we move in scope, think about what we’ve done with modernisation, your practices are living this and in particular we’ve seen electronic prescribing.
We’ve had had 94- I’m sorry, 98 per cent of pharmacies have so far participated in electronic prescribing, and have dispensed over 30 million electronic prescriptions. That’s a fundamental base going forward.
At the same time, we’ve been able to deliver and maintain a continuous dispensing, and that becomes permanent as of 1 July, moving up from where it was before the pandemic to a greater range of groups as of that day.
And we put in place real time prescription monitoring, which helps you deal with the health needs of patients who in many cases, might be in extremis.
And it gives you both security, but it allows you to be better health professionals and protecting the consumer. And I think that those are hugely important destinations that we will build on going forwards.
But you’re also businesses, viability is incredibly important. The PBS is our fundamental commitment.
And we’ve listed 2800 medicines, but we guaranteed that there would never be another period in Australian history, on our watch, with medicines that were approved would be stopped again as they were in 2011.
History won’t always tell you the future, but it’s the best guide for the future, and under us we never stopped testing those medicines. And they’ve been embraced, embraced by the whole of the government,
And even today, delighted to announce that a new medicine will be available in our pharmacies. From 1 May, Ofev, for 1400 patients with progressive fibrosis of the lungs.
And it costs $40,000 and now it’s available in our pharmacies. And that will make a life-saving difference for those patients. And there is $5 billion for new medicines which is available. And this will be the biggest Budget ever for the listing of new medicines.
But related to that, is what we do to support our businesses. And in particular, we put in place JobKeeper. 2,000 pharmacies- at least last year, 2000 pharmacies had to draw upon JobKeeper.
And whilst those in the suburbs had some challenging times, but in many cases had very large numbers of people coming to them, those in shopping centres and those in the inner cities faced enormous existential challenges as businesses, where lockdowns were put in place, even in my home city of Melbourne, inner Melbourne is still facing those challenges.
But 2000 of our community pharmacies were supported with JobKeeper. But going forwards, a 25 per cent tax rate, the instant asset write off, which we’ve been able to use.
And then all of these things coming together in the rural workforce, as Angie was raising with me, 1000 pharmacies under the seven community pharmacies that have had access to rural workforce supports, a massive increase in the number of participating pharmacies.
So that brings us beyond the five years that we mentioned, and today, in terms of vaccination, there are two things I’m really pleased to be able to share with you and to announce.
Firstly, the annual flu program will begin on 4 April. We’ve been able to get all states and territories bar one so far to agree to your full participation in the National Immunisation Program. Queensland, we were down to the last one- I wrote to just yesterday to urge them, and we need your support to make it a full eight, to make sure every state and territory will be on board. But that’s a massive move.
At the same time, we announced this morning, and I’m announcing with you, that the winter dose – the fourth dose for the over-65, for the immunocompromised, for Indigenous Australians over 50, and for those in residential aged care and disability residential care will be available also from 4 April. And pharmacy will play such a huge role in delivering those.
We’ll work with you and continue to expand that, but in particular, Trent raised the issue of affordable medicines.
I’m pleased to be able to announce the $26 million brought forward to support the programs today for the rest of this year. But in terms of the affordable medicines – obviously the PBS – but in particular we’ve already done work with regards to reducing the number of scripts that people need to pay, both the concessional and non-concessional patients, in order to access the safety net. And there will be more in the coming weeks on this.
So a lot of time, a lot about recognising that we have to support both concessional and non-concessional patients. 94 per cent of those scripts where there is a co-payment for scripts, as you know better than me, required co-payment, 94 per cent involved concessional patients. So we need this deal with both groups going forwards and we’re working through that.
But there will be some very significant announcements in the coming weeks. There are differing ways and different approaches, but affordable medicines for patients is something we’ve done, but it’s something we’ll be doing more on, and I give you that guarantee today.
And then finally, the last thing as I appear before APP, I want to announce is that our pharmacies, following on from the Royal Commission into Aged Care, will play a fundamental role in dispensing medicines and being embedded within our residential aged care facilities – particularly our oldest, most frail Australians.
$345 million commencing on 1 January 2023 over the next four years to support pharmacy involvement. And over the next six months, we’ll work in a period of co-design, with the Guild and with other elements across our health system to design and to implement that model.
But embedded pharmacy within aged care, with a $345 million contribution, will make a difference to saving lives, and protecting lives, and improving lives in aged care.
The very last thing I want to do is to say to everybody who’ve been on the frontline, to all of you have been there through the pandemic, to all of you have been supporting older Australians and people with mental health challenges and people who are lonely, as, and I couldn’t do this without mentioning this: as the grandson of Phyllis Grant, one of the first female pharmacists in Australia, I look out and it has been my honour to help support you, support the community.
But I respect you, I honour you, and above all else, I thank the Pharmacists of Australia.